Document Detail

Aortocaval fistula: current management strategies.
MedLine Citation:
PMID:  23072669     Owner:  NLM     Status:  Publisher    
BACKGROUND: There has been a trend towards favouring endovascular repair for much acute aortic pathology. We undertook a review of the literature to determine if an endovascular approach could complement the traditional treatment of aortocaval fistula (ACF), a rare complication of abdominal aortic aneurysm. METHODS: A literature search was undertaken on PubMed using appropriate search terms. Case series and reviews reporting presentation, diagnosis and operative management (open and endovascular techniques) of ACF were selected and discussed. RESULTS: Open surgical treatment of ACF has an associated morbidity and mortality - mainly from excessive blood loss. Open repair mortality rates are reported around 30%, but some centres report far lower rates based on preoperative diagnosis of the ACF. These rates appear to be reduced when using endovascular repair in selected cases, with success rates of up to 96%. Reiteration of the importance of diagnosis of ACF preoperatively was the common denominator with both open and endovascular repair. CONCLUSIONS: Endovascular exclusion appears to be an efficacious means of treating ACF and averting the significant blood loss commonly encountered in conventional repair of these lesions. However, some reviews have suggested equal success with open repair. There is limited available published literature on ACF management and outcome, and likely reporting bias attached to both open and endovascular results that are published. With a randomized controlled trial unlikely to occur, a prospective registry may provide better outcome data.
Robert E Brightwell; Victoria Pegna; Nicholas Boyne
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-16
Journal Detail:
Title:  ANZ journal of surgery     Volume:  -     ISSN:  1445-2197     ISO Abbreviation:  ANZ J Surg     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101086634     Medline TA:  ANZ J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.
Department of Vascular Surgery, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia; Department of Biosurgery, Oncology and Technology, Imperial College London, St Mary's Hospital, London, UK.
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